scholarly journals Age-dependent association between SARS-CoV-2 cases reported by passive surveillance and viral load in wastewater

2021 ◽  
Author(s):  
Ryosuke Omori ◽  
Fuminari Miura ◽  
Masaaki Kitajima
Keyword(s):  
Time Series ◽  
Viral Load ◽  
Time Lag ◽  
Age Groups ◽  
Age Group ◽  
Passive Surveillance ◽  
Northern Area ◽  
Viral Loads ◽  
Southern Area ◽  
Age Dependent

The true number of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is difficult to estimate using a case-reporting system (i.e., passive surveillance) alone because of asymptomatic infection. While wastewater-based epidemiology has been implemented as an alternative/additional monitoring tool to reduce reporting bias, the relationship between passive and wastewater surveillance data has yet to be explicitly examined. Since there is strong age dependency in the symptomatic ratio of SARS-CoV-2 infections, this study aimed to estimate i) an age-dependent association between the number of reported cases and the viral load in wastewater and ii) the time lag between those time series. The viral load in wastewater was modeled as a combination of contributions from different age groups' virus shedding, incorporating the delay, and fitted with daily case count data collected from the Massachusetts Department of Public Health and SARS-CoV-2 RNA concentrations in wastewater collected by the Massachusetts Water Resources Authority. The estimated lag between the time series of viral loads in wastewater and of reported cases was 10.8 days (95% confidence interval =[10.2, 11.6]) for wastewater treatment plant's northern area and 8.8 days [8.4, 9.1] for southern area. The estimated contribution rate of a reported case to the viral load in wastewater in the 0-19 yr age group was 0.38 [0.35, 0.41] for northern area and 0.40 [0.37, 0.43] for southern area, that in the 80+ yr age group was 0.67 [0.65, 0.69] for northern area and 0.51 [0.49, 0.52] for southern area. The estimated lag between those time series suggested the predictability of reported cases ten days later using viral loads in wastewater. The contribution of a reported case in passive surveillance to the viral load in wastewater differed by age, suggesting a large variation in viral shedding kinetics among age groups.

scholarly journals Seasonality in extra-pulmonary tuberculosis notifications in Germany 2004-2014- a time series analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tanja Charles ◽  
Matthias Eckardt ◽  
Basel Karo ◽  
Walter Haas ◽  
Stefan Kröger
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Disease Onset ◽  
Age Groups ◽  
Age Group ◽  
Pulmonary Tb ◽  
Series Analysis ◽  
Disease Site ◽  
Extra Pulmonary

Abstract Background Seasonality in tuberculosis (TB) has been found in different parts of the world, showing a peak in spring/summer and a trough in autumn/winter. The evidence is less clear which factors drive seasonality. It was our aim to identify and evaluate seasonality in the notifications of TB in Germany, additionally investigating the possible variance of seasonality by disease site, sex and age group. Methods We conducted an integer-valued time series analysis using national surveillance data. We analysed the reported monthly numbers of started treatments between 2004 and 2014 for all notified TB cases and stratified by disease site, sex and age group. Results We detected seasonality in the extra-pulmonary TB cases (N = 11,219), with peaks in late spring/summer and troughs in fall/winter. For all TB notifications together (N = 51,090) and for pulmonary TB only (N = 39,714) we did not find a distinct seasonality. Additional stratified analyses did not reveal any clear differences between age groups, the sexes, or between active and passive case finding. Conclusion We found seasonality in extra-pulmonary TB only, indicating that seasonality of disease onset might be specific to the disease site. This could point towards differences in disease progression between the different clinical disease manifestations. Sex appears not to be an important driver of seasonality, whereas the role of age remains unclear as this could not be sufficiently investigated.

scholarly journals 1465. Age-Dependent Interactions Among Clinical Characteristics, Viral Loads and Disease Severity in Young Children with Respiratory Syncytial Virus Infection (RSV) Infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S734-S735
Author(s):  
Helena Brenes-Chacon ◽  
Cristina Garcia-Maurino ◽  
Melissa Moore-Clingenpeel ◽  
Sara Mertz ◽  
Fang Ye ◽  
...  
Keyword(s):  
Young Children ◽  
Disease Severity ◽  
Age Groups ◽  
Panel Member ◽  
Signs And Symptoms ◽  
Research Support ◽  
Review Panel ◽  
Viral Loads ◽  
Age Dependent ◽  
Rsv Infection

Abstract Background Differences in clinical presentation and viral loads according to age in young children with RSV, and their correlation with disease severity are poorly defined. The aim of this study was to define age-dependent the differences in demographic, clinical factors and viral loads between children < 2 years of age with mild RSV infection evaluated as outpatients versus those hospitalized with severe RSV infection. Figure 1. Sign and Symptoms according to disease severity and age in infants with RSV infection. Most relevant signs and symptoms were stratified in outpatients (orange) vs inpatients (blue) by age in (A) < 3 months, (B) between 3 and 6 months, and (C) > 6 to 24 months of age. The Y axis represents the signs and symptoms in the two disease severity groups and the X axis the frequency of that specific symptom (%). Numbers next to bars represent the exact number of patients with that specific sign/symptom. Comparisons by Fisher exact test. Symbol (*) indicate significant 2-sided p values Figure 2. Viral load differences according to age in infants with RSV infection. The Y axis represents RSV loads in log10 copies/mL and the X axis differences in viral loads in outpatients (orange) and inpatients (blue) in the three age groups. Comparisons by Mann Whitney test. Methods Previously healthy children < 2 years old with mild (outpatients) and severe (inpatients) RSV infection were enrolled and nasopharyngeal swabs were obtained for RSV typing and quantitation by real-time PCR. Patients were stratified by age (0-< 3, 3-6, and >6-24 months) and multivariable analyses were performed to identify clinical and viral factors associated with severe disease. Results From 2014-2018 we enrolled 534 children with RSV infection: 130 outpatients and 404 inpatients. Median duration of illness was 4 days for both groups, yet viral loads were higher in outpatients than inpatient in the three age groups (Fig 1). Wheezing was more frequent in outpatients of older age (>3 months) than in inpatients (p< 0.01), while fever was more common in inpatients that outpatients (p< 0.01) and increased with age (Fig 2). Adjusted analyses confirmed that increased work of breathing and fever were consistently associated with hospitalization irrespective of age, while wheezing in infants >3 months, and higher RSV loads in children >6-24 months were independently associated with reduced disease severity. Conclusion Age had a significant impact defining the interactions among viral loads, specific clinical manifestations and disease severity in children with RSV infection. These observations highlight the importance of patient stratification when evaluating interventions against RSV. Disclosures Octavio Ramilo, MD, Bill & Melinda Gates Foundation (Grant/Research Support)Janssen (Grant/Research Support, Advisor or Review Panel member)Medimmune (Grant/Research Support)Merck (Advisor or Review Panel member)NIH/NIAID (Grant/Research Support)Pfizer (Consultant, Advisor or Review Panel member)Sanofi/Medimmune (Consultant, Advisor or Review Panel member) Asuncion Mejias, MD, PhD, MsCS, Janssen (Grant/Research Support, Advisor or Review Panel member)Merck (Advisor or Review Panel member)Roche (Advisor or Review Panel member)

scholarly journals Pedestrian Mortality Trends In Children Over Four Decades In Transitional Lithuania

2016 ◽  
Vol 26 (5) ◽  
pp. 13-19
Author(s):  
Birutė Strukčinskienė ◽  
Robert Bauer ◽  
Sigitas Griškonis ◽  
Vaiva Strukčinskaitė
Keyword(s):  
Time Series ◽  
Young People ◽  
Road Safety ◽  
Road Traffic ◽  
Age Groups ◽  
Age Group ◽  
Prevention Measures ◽  
Mortality Trends ◽  
Road Users ◽  
The Impact

The aim of the study was to examine the long-term trends in pedestrian mortality for children (aged 0 to 14 years) and young people (aged 15 to 19 years) over four decades in transitional Lithuania. Methods. Road traffic fatality data were obtained from Statistics Lithuania and the Archives of Health Information Centre. Trends were analysed by linear regression using “Independence” as a slopechanging intervention in 1991 and population as a further explanatory factor in structural time series models. Results. The impact of the interventions, along with the reforms and changes related with the Independence, on pedestrian fatality trends in our time series model was found highly statistically significant for children 0 to 14 years (p<0.001) and still significant for young people 15 to 19 years (p<0.05). No significant impact on the trend of road traffic deaths was found for the “control-groups” of non-pedestrian road users in the age group 0 to 14 years and adult pedestrians (over 19 years of age). For the age group 15 to 19 years the effect of reforms was also significant for non-pedestrians (p<0.05). These results indicate that the effect of measures and changes used in the post-independence period was more specific in children that participated in road traffic as pedestrians than in adult pedestrians, or in nonpedestrian road users. Conclusions. Pedestrian deaths in Lithuania fell significantly in the age groups 0-14 and 15-19 years. A declining trend was found in road traffic fatalities and in pedestrian deaths in transitional Lithuania in the post-independence period. Socioeconomic and political transformations, systematic reforms in healthcare along with sustainable preventive measures may have contributed to this decrease. Targeted road safety measures were road traffic regulations, pedestrian education and environmentally based prevention measures. As child pedestrians are the most vulnerable group of road users, continued road safety education and promotion are recommended in order to maintain this trend, and to involve adult pedestrians in this development.

scholarly journals Impact of skull base development on endonasal endoscopic surgical corridors

2014 ◽  
Vol 13 (2) ◽  
pp. 155-169 ◽  
Author(s):  
Matei A. Banu ◽  
Amancio Guerrero-Maldonado ◽  
Heather J. McCrea ◽  
Victor Garcia-Navarro ◽  
Mark M. Souweidane ◽  
...  
Keyword(s):  
Skull Base ◽  
Developmental Process ◽  
Normal Population ◽  
Age Groups ◽  
Age Group ◽  
Restriction Sites ◽  
Age Dependent ◽  
Skull Base Lesions ◽  
The Impact ◽  
Anatomical Parameters

Object Scarce morphometric data exist on the developing skull base as a corridor for endonasal endoscopic approaches (EEAs). Furthermore, the impact of skull base lesions on its development has not been assessed. The authors describe a novel set of anatomical parameters characterizing the developmental process as well as the utility of these parameters in preoperative planning and a feasibility assessment of EEAs for neurosurgical treatment of skull base lesions in children. Methods Based on specific MRI sequences in 107 pediatric patients (2–16 years of age) without skull base lesions (referred to here as the normal population), 3 sets of anatomical parameters were analyzed according to age group and sex: drilling distance, restriction sites, and working distance parameters. A separate set of patients undergoing EEAs was analyzed in similar fashion to address the impact of skull base lesions on the developmental process. Results The volume of the sphenoid sinus significantly increases with age, reaching 6866.4 mm3 in the 14–16 years age group, and directly correlates with the pneumatization type (r = 0.533, p = 0.0001). The pneumatization process progresses slowly in a temporal-posterior direction, as demonstrated by the growth trend of the sellar width (r = 0.428, p = 0.0001). Nasal restriction sites do not change significantly with age, with little impact on EEAs. The intercarotid distance is significantly different only in the extreme age groups (3.9 mm, p = 0.038), and has an important impact on the transsphenoidal angle and the intracranial dissection limits (r = 0.443, p < 0.0001). The 14.9° transsphenoidal angle at 2–4 years has a 37.6% significant increase in the 11–13 years age group (p = 0.001) and is highly dependent on pneumatization type. Age-dependent differences between working parameters are mostly noted for the extreme age groups, such as the 8.6-mm increase in nare-vomer distance (p = 0.025). The nare-sellar distance is the only parameter with significant differences based on sex. Skull base lesions induce a high degree of variance in skull base measurements, delaying development and decreasing parameter values. Skull base parameters are interdependent. Nare-sellar distance can be used to assess global skull base development because it highly correlates with the intercarotid distance in both the normal population and in patients harboring skull base lesions. Conclusions Skull base development is a slow, gradual, age-dependent, sex-independent process significantly altering endonasal endoscopic corridors. Preoperative MRI measurements of the pediatric skull base are thus a useful adjunct in choosing the appropriate corridor and in assessing working angles and limits during dissection or reparative surgery. Skull base lesions can significantly impact normal skull base development and age-dependent growth patterns.

scholarly journals Age-dependent pathogenic characteristics of SARS-CoV-2 infection in ferrets

2021 ◽  
Author(s):  
Young-Il Kim ◽  
Kwang-Min Yu ◽  
June-Young Koh ◽  
Eun-Ha Kim ◽  
Se-Mi Kim ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Age Groups ◽  
Type I ◽  
Activated T Cells ◽  
Virus Shedding ◽  
Viral Loads ◽  
Gene Sets ◽  
M1 Macrophage ◽  
Age Dependent ◽  
Severe Lung

Abstract While the seroprevalence of SARS-CoV-2 in healthy people does not differ significantly among age groups, those aged 65 years or older exhibit strikingly higher COVID-19 mortality compared to younger individuals. To further understand differing COVID-19 manifestations in patients of different ages, three age groups of ferrets were infected with SARS-CoV-2. Although SARS-CoV-2 was isolated from all ferrets regardless of age, aged ferrets (≥ 3 years old) showed higher viral loads, longer nasal virus shedding, and more severe lung inflammatory cell infiltration and clinical symptoms compared to juvenile (≤ 6 months) and young adult (1–2 years) groups. Transcriptome analysis of aged ferret lungs revealed strong enrichment of gene sets related to type I interferon, activated T cells, and M1 macrophage responses, mimicking the gene expression profile of severe COVID-19 patients. Thus, SARS-CoV-2-infected aged ferrets highly recapitulate COVID-19 patients with severe symptoms and are useful for understanding age-associated infection, transmission, and pathogenesis of SARS-CoV-2.

ASSESSMENT OF THE PREVALENCE OF DISEASES OF THE CIRCULATORY SYSTEM IN TRANSPORT INDUSTRY WORKERS IN VARIOUS AGE GROUPS

2021 ◽  
Author(s):  
A.G. Khotuleva ◽  
◽  
A.V. Karpushina ◽  
L.P. Kuzmina
Keyword(s):  
Cardiovascular System ◽  
Gradual Increase ◽  
Age Groups ◽  
Circulatory System ◽  
Frequency Of Occurrence ◽  
Age Group ◽  
Permanent Disability ◽  
Age Dependent ◽  
Transport Industry ◽  
Medical Examinations

Abstract. Summary. The leading cause of mortality, temporary and permanent disability is "age-dependent" (age-associated) diseases, the main of which are pathologies of the cardiovascular system. The aim of this study was to analyze the prevalence of diseases of the circulatory system in workers of the transport industry in various age groups. Materials and methods. The data of objective periodic and preliminary medical examinations conducted in the FSBSI «Izmerov Research Institute of Occupational Health», among Metro employees for people, were analyzed. The assessment was carried out in various age groups, starting from the age of 30 to 70 years (in increments of 5 years). The prevalence of diseases of the circulatory system in workers of different ages was analyzed. Results. There is a pronounced tendency to increase the prevalence of diseases of the cardiovascular system with age in Metro workers. There was a significant increase in the relative risk of diseases characterized by high blood pressure in all age groups relative to the previous age group, except for the 70-74 year group, in which the risk does not increase relative to the 65-69 year group, which indicates a gradual increase in the prevalence of the disease with increasing age. The prevalence of coronary heart disease (CHD) was also estimated. An increase in the frequency of occurrence of this pathology has been shown from the age of 55-59 years.

scholarly journals Vaccination Prioritization Strategies for COVID-19 in Korea: A Mathematical Modeling Approach

2021 ◽  
Vol 18 (8) ◽  
pp. 4240
Author(s):  
Yongin Choi ◽  
James Slghee Kim ◽  
Jung Eun Kim ◽  
Heejin Choi ◽  
Chang Hyeong Lee
Keyword(s):  
Age Groups ◽  
Epidemiological Data ◽  
The Elderly ◽  
Age Group ◽  
Elderly Age ◽  
Social Distancing ◽  
Vaccination Strategies ◽  
Effective Age ◽  
Incidence And Mortality ◽  
Age Dependent

Coronavirus disease 2019 (COVID-19) vaccination has recently started worldwide. As the vaccine supply will be limited for a considerable period of time in many countries, it is important to devise the effective vaccination strategies that reduce the number of deaths and incidence of infection. One of the characteristics of COVID-19 is that the symptom, severity, and mortality of the disease differ by age. Thus, when the vaccination supply is limited, age-dependent vaccination priority strategy should be implemented to minimize the incidences and mortalities. In this study, we developed an age-structured model for describing the transmission dynamics of COVID-19, including vaccination. Using the model and actual epidemiological data in Korea, we estimated the infection probability for each age group under different levels of social distancing implemented in Korea and investigated the effective age-dependent vaccination strategies to reduce the confirmed cases and fatalities of COVID-19. We found that, in a lower level of social distancing, vaccination priority for the age groups with the highest transmission rates will reduce the incidence mostly, but, in higher levels of social distancing, prioritizing vaccination for the elderly age group reduces the infection incidences more effectively. To reduce mortalities, vaccination priority for the elderly age group is the best strategy in all scenarios of levels of social distancing. Furthermore, we investigated the effect of vaccine supply and efficacy on the reduction in incidence and mortality.

scholarly journals Monitoring and predicting SARS-CoV-2 epidemic in France after deconfinement using a multiscale age-stratified rate model

2020 ◽  
Author(s):  
Juergen Reingruber ◽  
Andrea Papale ◽  
David holcman
Keyword(s):  
Health Care ◽  
Age Groups ◽  
Economic Life ◽  
Reproduction Rate ◽  
Age Group ◽  
Rate Model ◽  
Age Dependent ◽  
Predictive Approaches ◽  
The Impact ◽  
Second Peak

The entire world and France were strongly impacted by the SARS-COV-2 epidemic. Finding appropriate measures that effectively contain the spread of the epidemic without putting a too severe pressure on social and economic life is major challenge for modern predictive approaches. To assess the impact of confinement (March 17th till May 11th) and deconfinement, we develop a novel rate model to monitor and predict the spread of the epidemic and its impact on the health care system. The model accounts for age-dependent interactions between population groups and predicts consequences for various infection categories such as number of infected, hospitalized, load of intensive care units (ICU), number of death, recovered and more. We use online health care data for the five most infected regions of France to calibrate the model. At day of deconfinement (May 11th), we find that 13% (around 4.8M) of the population is infected in the five most affected regions of France (extrapolating to 5.8M for France). The model predicts that if the reproduction rate R0 is reduced by at least a factor of 2.5-3 for all age groups, which could be achieved by wearing masks and social distancing, a significant second peak could be prevented. However, if the reduction in R0 for the age group 0-25 would be less and below 2 (school openings), a second peak is unavoidable in which case the ICU will be saturated. In that context testing should be focused on children, but it will nevertheless have a limited impact on reducing the spread.

scholarly journals Evaluation of the SARS-CoV-2 positivity ratio and upper respiratory tract viral load among asymptomatic individuals screened before hospitalization or surgery in Flanders, Belgium

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259908
Author(s):  
Laura Heireman ◽  
Steven Abrams ◽  
Peggy Bruynseels ◽  
Reinoud Cartuyvels ◽  
Lize Cuypers ◽  
...  
Keyword(s):  
Viral Load ◽  
Respiratory Tract ◽  
Age Group ◽  
Test Results ◽  
Rt Pcr ◽  
Median Viral Load ◽  
Viral Loads ◽  
Asymptomatic Patients ◽  
Positivity Ratio ◽  
Second Wave

Introduction The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in the Belgian community is mainly estimated based on test results of patients with coronavirus disease (COVID-19)-like symptoms. The aim of this study was to investigate the evolution of the SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) positivity ratio and distribution of viral loads within a cohort of asymptomatic patients screened prior hospitalization or surgery, stratified by age category. Materials/Methods We retrospectively studied data on SARS-CoV-2 real-time RT-PCR detection in respiratory tract samples of asymptomatic patients screened pre-hospitalization or pre-surgery in nine Belgian hospitals located in Flanders over a 12-month period (1 April 2020–31 March 2021). Results In total, 255925 SARS-CoV-2 RT-PCR test results and 2421 positive results for which a viral load was reported, were included in this study. An unweighted overall SARS-CoV-2 real-time RT-PCR positivity ratio of 1.27% was observed with strong spatiotemporal differences. SARS-CoV-2 circulated predominantly in 80+ year old individuals across all time periods except between the first and second COVID-19 wave and in 20–30 year old individuals before the second COVID-19 wave. In contrast to the first wave, a significantly higher positivity ratio was observed for the 20–40 age group in addition to the 80+ age group compared to the other age groups during the second wave. The median viral load follows a similar temporal evolution as the positivity rate with an increase ahead of the second wave and highest viral loads observed for 80+ year old individuals. Conclusion There was a high SARS-CoV-2 circulation among asymptomatic patients with a predominance and highest viral loads observed in the elderly. Moreover, ahead of the second COVID-19 wave an increase in median viral load was noted with the highest overall positivity ratio observed in 20–30 year old individuals, indicating they could have been the hidden drivers of this wave.

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